These are the 10 unhealthiest states in the US

For the 28th year in a row, the United Health Foundation has ranked America’s states based on factors including obesity, air pollution, and poverty. Massachusetts made the top of the list as America’s healthiest state, while Mississippi was declared the unhealthiest.

Here’s a map, with the healthiest states in light blue and the least healthy in dark blue.

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United Health Foundation

Looking at data from the Centers for Disease Control and Prevention, the American Medical Association, and the Census bureau, the rankings took into account everything from obesity and smoking to community and environmental factors, such as child poverty and air pollution, to public policies like immunizations, and health outcomes like cancer deaths and diabetes.

Massachusetts ranked the healthiest state for the first time in the ranking’s 28-year history. “Massachusetts’ strengths include the lowest percentage of uninsured at 2.7% of the population, a low prevalence of obesity and a high number of mental health providers,” the report said.

It was followed by Hawaii, Vermont, Utah, and Connecticut to round out the top five healthiest states.

At the same time, the UHF noted some troubling trends: premature death (that is, deaths that occur before an older age) rate and the drug death rate have both been increasing.

Here’s the list of the 10 unhealthiest states, according to the report.

41. Georgia has among the least physically active states, some of the highest child poverty rates, and a relatively high percentage of uninsured people. On a more positive note, Georgia was among the states with the least drug overdose death rates.

42. Kentucky, which rose in the rankings from 45 in 2016, has a high prevalence of smoking, along with the highest rate of cancer deaths. Kentucky also had the second highest rate of drug deaths, next to West Virginia. The state also has one of the lowest uninsured rates in the US.

43. Oklahoma, which also rose in the rankings from 2016 when it came in at 46, has a high cardiovascular death rate. Oklahoma also was among the states with the highest uninsured rate, while having a relatively high number of mental health providers.

44. South Carolina has a fairly high infectious disease rate and at the same time has low teen vaccination rates. The state also has a relatively low number of dentists.

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45. Tennessee has a relatively high obesity rate, and a high prevalence of smoking. The state also has among the highest violent crime rates in the country.

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46. West Virginia has the highest rate of drug overdose deaths in the US, the highest rate of obesity, and the highest rate of smoking, though it also one of the most insured populations in the country and had the highest rate of public health funding per person.

49. Louisiana, has high rates of obesity, physical inactivity, and infant mortality. It also had the highest rate of infection in the US.

50. Mississippi ranked as o the state with the highest rate of cardiovascular deaths, has a high smoking prevalence, and a high rate of children in poverty. The state does have a relatively low rate of drug overdose deaths.